Blunt popliteal artery injury with complete lower limb ischemia: is routine use of temporary intraluminal arterial shunt justified?

Abstract

Temporary arterial shunting after blunt lower limb trauma significantly reduces total ischemic time, complications, repeat operations, amputation, and hospitalization. I recommend routine use of shunts in blunt popliteal artery injuries with complete lower limb ischemia.

Management of traumatic popliteal vascular injuries in a level I trauma center: A 6-year experience

“…The use of TIVS is associated with thrombosis rate of 5% with TIVS, amputation rates of 18%, and an overall survival rate of 73% [18]. Hossny et al has shown that TIVS is associated with reduced intraoperative ischemic time, complications, repeat operations, amputation rates (overall limb salvage rate of 76.5%), and hospital length of stay [4]. Therefore, they advocate the routine use of TIVS in blunt popliteal artery injuries with complete lower limb ischemia [4].…”

“…Hossny et al has shown that TIVS is associated with reduced intraoperative ischemic time, complications, repeat operations, amputation rates (overall limb salvage rate of 76.5%), and hospital length of stay [4]. Therefore, they advocate the routine use of TIVS in blunt popliteal artery injuries with complete lower limb ischemia [4]. On the other hand, Huynh et al avoided the use TIVS as opposed with an early vascular repair.…”

Computed tomographic angiography in pediatric blunt traumatic vascular injury

“…This is most evident with popliteal artery injuries where the diagnosis can be difficult to make and delay leads to higher rates of neuropathy and amputation [9]. Both of these complications can be directly attributable to prolonged ischemia time [10]. The tools at our disposal for making the correct diagnosis are knowledge of the mechanism of injury, physical examination, and diagnostic imaging modalities.…”

Surgical Damage Control and Temporary Vascular Shunts

“…[13][14][15][16][17][18][19][20] One bittersweet effect of wartime is the renaissance of surgical experience, technology, and technique. In a report from Operation Iraqi Freedom (OIF), Rasmussen et al described a 1-year experience of 126 extremity vascular injuries, in which 30 temporary vascular shunts were utilized in the management of vascular injury.…”